International Journal

Clinical Image

A 65-year-old healthy woman presented with a 3-month history of a palpable painful nodule in the left foot (Figure 1A). There was neither family history of similar nodules nor history of trauma. The patient was taking no medication. Physical examination confirmed the presence of a single soft palpable mass on the medial aspect of the plantar arch. Subsequent ultrasound revealed a fusiform nodular thickening of the plantar fascia, with a hypoechoic structure, of about 1 cm (Figure 1B). There was no vascular flow on color Doppler. The findings were compatible with plantar fibromatosis, also known as Ledderhose´s disease. Ledderhose´s disease is a rare, benign, hyperproliferative disorder of the plantar Apo neurosis. Patients present one or more nodules, painful or not, on the medial aspect of the plantar arch. It is generally seen in middle-aged and elderly and is more common in men. Patients may suffer from other fibrosing disorders such as Dupuytren´s contracture, Peyronie´s disease, or knuckle pads. The main differential diagnosis is plantar fasciitis. Treatment is usually conservative but surgery or radiation might be used in selected cases. The patient was referred to orthopedics.

Keywords: Ledderhose´s disease; Peyronie´s disease; Hyperproliferative disorder